Project Summary Patients and their families often have difficulty managing medications, especially across transitions of care. Two-thirds of all adverse events following hospital discharge are related to medications. The problem of medication management is magnified for older patients, who are often on multiple medications and for whom side effects and drug-drug interactions may lead to more harm. InfoSAGE (Information Sharing Across Generations) is an existing AHRQ-supported research project that seeks to understand and address information and care coordination needs of older adults, age 75 and above, and their families who are involved in their care. Research participants use an online private social network, built for the project (https://www.infosagehealth.org), to find resources and manage tasks and communications. Our approach uses health information technology in a new way, creating a community-based platform to improve care coordination, patient and family empowerment, and ultimately improve patient safety. In this project, we propose to expand the functionality of the InfoSAGE platform to include a mobile-first/point- of-care medication manager to help elderly people and their families keep an accurate medication list, coordinate the list with the prescribing clinicians, track the impact of medications on symptoms, view medication precautions and drug-drug interactions, and become more engaged as partners in their care. We will determine facilitators and barriers to the use of a shared online medication list, assess the usability and e-Health literacy needed for the tool, and measure its adoption and usage. We will then study the impact of the tool on medication safety and determine if increased engagement with the tool improves shared decision- making about medications and reduces the inappropriate use of medications and polypharmacy. Our long-term goal is to develop a set of best practices for the use of online and mobile tools for complex medication management.